Neuropsychological outcome of operated cerebral aneurysms: prognostic factors on 148 patients

• Published in: Acta neurologica Scandinavica Vol. 97; no. 6; pp. 393 - 397
• Main Authors: Santis, A. De, Laiacona, M., Barbarotto, R., Divitiis, O. De, Migliore, M., Capitani, E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.1998; Blackwell
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Disease Progression; Educational Status; Female; Humans; Intracranial Aneurysm - complications; Intracranial Aneurysm - surgery; intracranial aneurysms; Male; Medical sciences; Middle Aged; Neurology; neuropsychological outcome; Neuropsychological Tests; Prognosis; prognostic factors; Retrospective Studies; timing of surgery; Vascular diseases and vascular malformations of the nervous system; Human; Postoperative; Intracranial; Nervous system diseases; Aneurysm; Neuropsychological test; Cardiovascular disease; Exploration; Psychometrics; Artery; Cerebral disorder; Arterial disease; Vascular disease; Central nervous system disease; Evolution; Cerebrovascular disease
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/j.1600-0404.1998.tb05972.x

Objectives – To analyse prognostic factors in patients operated upon for cerebral aneurysms. A previous investigation by our group showed that patients operated later than 10 days after bleeding have a worse neuropsychological prognosis, but the number of patients operated upon within 3 days was not sufficient. Here, a new sample of patients with early surgery is included in the analyses. Material and methods – Patients numbered 148 (65 with ACoA, 39 with MCA, and 44 with PCoA aneurysms): 56 were operated within 3 days, 44 within 4‐10 days, and 48 after at least 10 days from bleeding. A standardized battery of 13 neuropsychological tests was adopted: we considered both the number of defective scores and the average performance. Results – Patients operated later than 10 days after bleeding had a worse prognosis than the 2 groups with early and intermediate surgery, which were not different. Aneurysm site was not relevant. Old age and low education were associated with a worse prognosis. Hunt and Hess scores at operation and post operation were also predictive of the outcome. Conclusion – On the whole, patients operated upon later than 10 days after bleeding have a less favourable prognosis than those with earlier operation timing.